Doctors in Puerto Rico can issue health certificates without a tuberculosis skin test or blood test when an applicant’s risk-and-symptom screening finds no risk factors or symptoms, under a Health Department administrative order announced Oct. 13.
Administrative Order 2026-654, signed Oct. 7, lets doctors use an individual risk-and-symptom evaluation on a department form instead of the test. Neither the tuberculin skin test nor the IGRA blood test is required when the evaluation finds no risk factors or symptoms.
For applicants with risk factors, the doctor decides whether a skin test, blood test or other evaluation is needed. Anyone with signs or symptoms that suggest tuberculosis must be evaluated to rule out active disease before a certificate is issued. The order sets no end date. The department announced it Oct. 13.
The department said the change responds to a shortage of tuberculin.
Questions can go to the department’s tuberculosis program at (787) 765-2929, extensions 3866 and 3868.
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Sources: Puerto Rico Department of Health, Administrative Order 2026-654, signed Oct. 7, 2026; department news release, Oct. 13, 2026.
